Provider Demographics
NPI:1427116755
Name:GOLDEN, DONNA (NP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1770
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-1143
Mailing Address - Country:US
Mailing Address - Phone:603-212-9600
Mailing Address - Fax:603-212-9601
Practice Address - Street 1:99 LONGWATER CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1642
Practice Address - Country:US
Practice Address - Phone:781-659-1800
Practice Address - Fax:781-659-7221
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA136764363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQ16485Medicare UPIN
MANP4576Medicare ID - Type UnspecifiedPROVIDER NUMBER